Features of Iffco Tokio Health Insurance

    • No. of members- The plan covers maximum 5 members of your family with up to 3 children and 2 adults.
    • Lifelong Renewal – The plans offered are lifelong renewable, hence it saves you from the financial burden and stress caused by a medical emergency and keeps you well prepared to handle any situation.
    • Pre & Post hospitalization cover- The plan covers medical expenses for 60 days prior to hospitalization and 60 days post hospitalization only for related medical expenses.
    • Health Check-ups – On successful completion of 4 claim-free years, the health check-up expenses are reimbursed up to maximum 1% of the average sum insured.
    • Pre-existing diseases- Pre-existing diseases are covered after 3 years of waiting period.
    • Co-payment- The plan has no co-payment policy.

Benefits of Buying Health Insurance from Iffco Tokio Health Insurance

  • Trusted Brand: With Tokio Marine & Nichico Fire Insurance Company, the oldest insurance company in Japan, as its promoter, IFFCO Tokio has the expertise in the insurance vertical. It is one of the largest and popular insurance companies with a loyal customer base.
  • Ideal Products: IFFCO Tokio health insurance designs products keeping their audience in mind and you are bound to find a health insurance plan that suits you the best.
  • Strong network of hospitals: With a PAN India presence, Iffco Tokio has a strong network of hospitals for cashless hospitalization.
  • Claim settlement: With minimal rejection ratio, IFFCO Tokio health insurance comes on top when it comes to claim settlements.

Products offered by Iffco Tokio Health Insurance

Individual Medishield Insurance Policy- Base Plan

This is the most basic health insurance plan offered by IFFCO TOKIO with coverage as follows:

  • This policy offers basic coverage in the range of Rs.1 lakh and Rs.5 lakh for individuals of between age 5 years and 65 years.
  • Pre and post hospitalization expenses, no claim bonus, day care procedures, coverage for expenses on treatments using Ayurveda, etc., are benefits provided in this plan.
  • The plan has sub-limits (limits on room-rent, ICU rent, etc.) as specified in the policy.

Individual Medishield Insurance Policy- Base Plan Plus Critical Care

  • This Individual health insurance policy offers benefit of additional coverage of Rs.1 lakh to the base cover (mentioned above) after payment of 30 % more premium of the base plan premium.
  • Individuals between age 5 years and 65 years would be covered under this policy.
  • This is an extension of base plan, which provides double coverage in case of critical illness. Pre and post hospitalization expenses, no claim bonus, day care procedures, coverage for expenses on treatments using Ayurveda, etc., are benefits provided in the plan.
  • The plan has sub-limits (limits on Room rent, ICU rent, etc.) as specified in the policy.

Health Protector

This is a health insurance plan with co-payment. Here is a brief on coverage offered:

  • This plan offers coverage during illnesses/ injuries/ diseases that require hospitalization.
  • Basic cover like pre and post hospitalization expenses, no claim bonus, day care procedures, coverage for expenses on treatments using Ayurveda, etc., are benefits provided in the plan.
  • The plan has co-payment after first claim in the range of 7.5% to 20%.

Individual Personal Accident Insurance policy

This is personal accident disability plan offered by IFFCO TOKIO. The details of coverage offered is as follows:

  • This plan offers coverage in case of accidents in the range of Rs.2.5 lakh to Rs. 15 lakh to individuals below age 65 years.
  • In this plan a lump sum amount in case is paid in case of accidental death, daily cash in case of illness & accident, it also covers permanent or temporary total disability, injuries with broken bones or burns as well as ambulance costs.

Health Protector Plus

Individual Coverage:

This is a top-up plan, which provides coverage in case the hospitalization expenses exceed the deductible value. Mentioned below is brief about coverage offered:

  • This is a top-up plan (these plans have an agreed upon deductible amount to be paid at the time of claim), which offers coverage to individuals between age 18 years up to 65 years.
  • The coverage amount for this plan is in the range of Rs.2 lakh and Rs.25 lakh and the deductible amount is in range of Rs.1 lakh and Rs.5 lakh.
  • The plan offers basic coverage like pre and post hospitalization expenses, no sub-limits, no-claim bonus, hospital expense cover, ambulance cover, etc.
  • There are 8 variants of this plan, which offers different sum insured values.

Family Floater Coverage :

  • This is a top-up plan (these plans have an agreed upon deductible amount to be paid at the time of claim) for individuals from age 18 years up to 65 years.
  • The coverage amount for this plan is in the range of Rs.2 lakh and Rs.25 lakh and the deductible amount is in the range of Rs.1 lakh and Rs.5 lakh.
  • The plan offers basic coverage like pre and post hospitalization expenses, no sub-limits, no-claim bonus, hospital expense cover, - -- There are 8 variants of this plan, which offers different sum insured values.

Swasthya Kavach Policy Base Plan

This is basic health insurance plan offered by IFFCO TOKIO to cover health expenses for the entire family on a shared basis. Some details of this plan are:

  • It offers coverage in the range of Rs.2 lakh and Rs.5 lakh.
  • A maximum of 2 adults and 3 children in the family between age 18 years and 60 years and dependent children between age 3 months and 23 years can be covered under this policy.
  • Pre and post hospitalization expenses, No sub-limits, No-claim bonus, cashless benefit, hospital expense cover, ambulance cover, etc., are provided in the plan.

Swasthya Kavach Policy Wider Plan

Swasthya Kavach Wider plan is advanced variant of the basic plan. The details of coverage offered are:

  • It in the range of Rs.2 lakh and Rs.5 lakh.
  • A maximum of 2 adults and 3 children in the family between age 18 years and 60 years and dependent children between age 3 months and 23 years can be covered under this policy.
  • The wider plan offers higher expense coverage in case of daily cash, reimbursement of health check-up cost, no sub-limits, etc.

Swasthya Kavach Policy Wider Plan with Critical Illness

This is advanced variant with additional coverage in case of diagnosis of critical illness. Here are some details of coverage offered.

  • This is a family floater plan, which covers health costs of the entire family in the range of Rs.2 lakh and Rs.5 lakh.
  • A maximum of 2 adults and 3 children in the family between age 18 years and 60 years and dependent children between age 3 months and 23 years can be covered under this policy.
  • In addition to providing wider coverage this health insurance plan provides additional critical illness coverage.

If you want to know more about the coverage offered under any variant of Swasthya Kavach plan, please click here.

Family Health Protector Policy: Iffco Tokio Family Health Protector Premium Chart

This is a health insurance plan, which covers expenses of entire family on shared basis. The details of coverage offered are as follows:

  • This is a family floater plan, which covers health costs of the entire family.
  • Illnesses or injuries or diseases, which require hospitalization, are covered in this plan.
  • Basic cover like pre and post hospitalization expenses, no claim bonus, day care procedures, coverage for expenses on treatment using Ayurveda, etc., are benefits provided in the plan.
  • This family health insurance plan has sub limits below sum insured Rs.7 lakh.

Iffco Tokio Health Insurance Claim Status

There are two ways to make claim under a Health Insurance Policy: on cashless basis and on reimbursement basis. In simple terms, for making a claim on cashless basis, the treatment must be done only at a network hospital of the insurance company servicing your policy. For availing the treatment, you would have to first seek an authorization as per the procedures laid down and in the prescribed form. In case of claims on reimbursement basis, the insurance company has to be informed as per their prescribed procedures. The policyholder has to ensure that documents such as claim form, discharge summary, prescriptions and bills to be submitted for the claim on reimbursement are obtained after hospitalization.
Religare Health Insurance has a well-defined claim processing system.

Cashless Service: Seeking Pre-Authorization

  • Complete the pre-authorization form available at the hospital's insurance/TPA Desk.
  • Send the completed form via email or fax.
  • Approved letter will be sent by the claim management team. Remember that the claim management team could send an inquiry to the hospital or you before authorization.
  • In case the authorization is rejected, initiate the treatment and file for reimbursement claim.

Reimbursement Claim: Claim Submission

  • Complete the necessary form and submit along with required documents, as per the policy terms and conditions.
  • Necessary documents include discharge summary, prescriptions, bills etc.
  • Approved letter will be sent by the claim management team. Remember that you will be answerable to any queries raised by the claim management team before the letter is issued.
  • In case the claim is rejected, the reasons will be communicated by the team.

In case of any emergencies, you need to inform Iffco Tokio within 24 hours of the admission. In case of planned emergencies, the notification has to reach the company 48 hours prior to the hospitalization. The claim intimation can be done via Iffco Tokio's toll free number 1-800-103-5499. The same could also be emailed to websupport@iffcotokio.co.in.

Iffco Tokio Health Insurance